The inframammary fold: Contents, clinical significance and implications for immediate breast reconstruction

Gerald P H Gui, K. A. Behranwala, Norlia Abdullah, J. Seet, P. Osin, A. Nerurkar, S. R. Lakhani

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

The amount of breast tissue within the inframammary fold (IMF) is controversial. Preservation of the IMF during mastectomy facilitates breast reconstruction and led some surgeons to practice conservation of the IMF, contrary to traditional descriptions of total mastectomy. The aim of this study was to analyse the clinical significance of IMF tissue content. A total of 50 IMF specimens were studied from 42 patients who underwent mastectomy between January 2001 and December 2002. The amount of breast tissue within each IMF was evaluated. The median patient age was 46 (range 33-86) years. The median body mass index was 23.4 (18.1-38.3) kg/m2. The median IMF volume resected was 2 (0.2-9.7) cm3 which was 0.6 (0.1-2.0)% of the breast volume. Ten specimens (20%) contained breast tissue and one (2%) contained breast tissue and an inframammary lymph node. Three specimens (6%) containing fibrofatty tissue without breast parenchyma had intramammary lymph nodes within the IMF. One patient (2%) who had a mastectomy for invasive ductal carcinoma had IMF tissue containing a lymph node within the IMF with breast cancer metastasis. The presence of breast tissue or lymph nodes within the IMF was unrelated to patient age, body mass index, the amount of IMF tissue in relation to breast volume and absolute breast size. Our finding that breast tissue and intramammary lymph nodes are present in 28% of IMF specimens requires re-consideration of the safety of preserving the IMF at mastectomy. If IMF tissue is resected and the immediate breast reconstruction is performed, the superficial fascial system should be reconstructed after excision of the IMF tissue in order to recreate the inframammary crease.

Original languageEnglish
Pages (from-to)146-149
Number of pages4
JournalBritish Journal of Plastic Surgery
Volume57
Issue number2
DOIs
Publication statusPublished - Mar 2004
Externally publishedYes

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Mammaplasty
Breast
Mastectomy
Lymph Nodes
Body Mass Index
Simple Mastectomy
Ductal Carcinoma

Keywords

  • Breast reconstruction
  • Inframammary fold
  • Intramammary lymph nodes

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Surgery

Cite this

The inframammary fold : Contents, clinical significance and implications for immediate breast reconstruction. / Gui, Gerald P H; Behranwala, K. A.; Abdullah, Norlia; Seet, J.; Osin, P.; Nerurkar, A.; Lakhani, S. R.

In: British Journal of Plastic Surgery, Vol. 57, No. 2, 03.2004, p. 146-149.

Research output: Contribution to journalArticle

Gui, Gerald P H ; Behranwala, K. A. ; Abdullah, Norlia ; Seet, J. ; Osin, P. ; Nerurkar, A. ; Lakhani, S. R. / The inframammary fold : Contents, clinical significance and implications for immediate breast reconstruction. In: British Journal of Plastic Surgery. 2004 ; Vol. 57, No. 2. pp. 146-149.
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